H1N1 flu
Back in May, QUEST first reported on the urgency and rush to develop the H1N1 vaccine featuring Art Reingold, head of epidemiology at the UC Berkeley School of Public Health. The concerns largely centered on our vulnerability to the virus, especially for healthy individuals. In September, QUEST updated the story on the race to distribute the vaccine before mutations inevitably take place.

The vulnerability translated to substantial number of deaths, estimated to be between 2,500 and 6,100 according to the CDC. There is good news on the horizon, as week to week indicators show both a decline in national doctor visits for the flu and there has been a substantial decline n number of states reporting widespread H1N1 activity.

This may be sign of the H1N1 outbreak peak, a figure Art Reingold has been closely monitoring for the past few months. He'll be discussing the epidemiology of the pandemic and the controversy over the vaccine.

To learn more about the H1N1 virus, call: (800) CDC-INFO (800 232-4636) or visit the CDC's website.

H1N1 Update with Dr. Art Reingold
When: Wednesday, December 9th, 7-9 PM
Where: Cafe Valparaiso at La Pena Cultural Center
Cost: Free
Details: Experts are predicting a substantial resurgence of swine flu cases this coming winter. Art Reingold will provide an update concerning the global pandemic of novel H1N1(swine) influenza; the current state of affairs in the US and California; and options for prevention, including a pandemic influenza vaccine.

Animal viruses can be more deadly than their human
counterparts
A lot of people have been commenting about the apparent overreaction of governments to the swine flu.  Why go to such extreme measures to deal with simple influenza?  The reason has to do with the flu pandemic of 1918-1919.

Over those two years, at least three waves of flu struck killing over 600,000 people in the U.S. and a staggering 30-50 million people worldwide.  People died at such a high rate that cities ran out of caskets and dead bodies were stacked on porches and in the streets.

Governments have been concerned that history might repeat itself because the two flues share one thing in common–they both started out as animal viruses.  And our bodies are not particularly good at fighting off viruses new to humans.

Each year a new flock of flu strains kicks off the flu season.  Almost always these strains are variations of human flues from previous years.  What this means is that we have seen cousins of these viruses in the past and so have a leg up on mounting an attack and defeating them.

We do not have this same leg up on animal viruses.  Our immune systems haven't seen anything like them and so can't mount a quick attack.  The end result is that the percentage of people who die from animal flues tends to be much higher than from run of the mill human flues.

In any flu season, the CDC estimates that 5-20% of the U.S. population ends up with the flu.  And that 36,000 of these people die.  The numbers of deaths would be much higher if a truly deadly animal flu virus like the bird flu from a few years back were to emerge and gain the ability to spread from person to person.  (The bird flu was never more than a few isolated cases since it never gained this ability.)

At first blush, this is what the swine flu looked like.  The disease spread easily among people and, in Mexico at least, appeared to be more deadly than normal flues.  So governments around the world sprang into action.  Since flu is spread through contact, governments tried to keep people away from each other.

They closed schools at the fist sign of trouble.  Mexico closed restaurants, theaters and museums too.  All of this was done in an attempt to prevent the spread of a disease like the flu of 1918.

At least outside of Mexico, this flu does not seem to be too much worse than other flues.  So it may be that governments overreacted this time.  But I would prefer that they overreact like this as opposed to ignoring a deadly pandemic.  We don't want another 1918 on our hands.

More info on The 1918 Flu in San Francisco

The swine flu virus. Credit: C. S. Goldsmith and A. Balish, CDC.

As this story is being produced, the reports on swine flu are changing hourly. Cases are popping up closer and closer to home, and the CDC is updating several times a day on the spread of the virus, and plans to fight it.

The $64,000 question is how worried we should be.

Swine flu is largely untreatable: The two effective antiviral drugs, Tamiflu and Relenza, must be taken within 48 hours of infection to stop the spread of the virus.

That leaves a vaccine. Vaccines are relatively straightforward to create, but they take time. If swine flu becomes a deadly pandemic (meaning it's not only widespread — a pandemic – but more lethal than it appears to be so far) the demand for vaccines would likely far outpace supply. According to Art Reingold, at UC Berkeley's School of Public Health, it could take years for doses to reach everyone in the world who's vulnerable to the disease. Here in the US, we have very few vaccine producing facilities, which means we'd be competing with other countries' priorities to treat their own citizens.

Our story focuses on what could, one day, be the answer to pandemics like this one: a universal vaccine. Scientists like Harvard Medical School's Wayne Marasco believe that, in just a few years, we might be able to inoculate ourselves against nearly all influenza viruses – like a tetanus shot, against the flu. Universal vaccines will come too late for our current swine flu pandemic. But they may well be our response to pandemics of the future.

Listen to the Swine Flu and You radio report online.